Ch 44: Pain Management
A nurse is caring for a patient with rheumatoid arthritis who is now going to be taking 2 acetaminophen (Tylenol) tablets every 6 hours to control pain. Which part of the patient's social history is the nurse most concerned about?
Patient drinks 1 to 2 glasses of wine every night.
A nurse is planning care for an older-adult patient who is experiencing pain. Which statement made by the nurse indicates the supervising nurse needs to follow up?
"As adults age, their ability to perceive pain decreases."
A nurse is caring for a group of patients. Which patient will the nurse see first?
A patient who received morphine and has a pulse of 62 beats/min, respirations 10 breaths/min, and blood pressure 110/60 mm Hg
The nurse is caring for a patient to ease modifiable factors that contribute to pain. Which areas did the nurse focus on with this patient?
Anxiety and fear
The nurse is caring for a patient who suddenly experiences chest pain. What is the nurse's first priority?
Ask the patient to rate and describe the pain.
A nurse is caring for a patient with chronic pain from arthritis. Which action is best for the nurse to take?
Give pain medications around the clock.
A nurse is teaching a patient about patient-controlled analgesia (PCA). Which statement made by the patient indicates to the nurse that teaching is effective?
"I feel less anxiety about the possibility of overdosing."
A nurse is caring for a patient with chronic pain. Which statement by the nurse indicates an understanding of pain management?
"I need to reassess the patient's pain 1 hour after administering oral pain medication."
A patient who has had type 2 diabetes for 26 years is beginning to experience peripheral neuropathy in the feet and lower leg. The nurse is providing education to the patient to prevent injury to the feet by wearing shoes or slippers when walking. Which statement made by the nurse best explains the rationale for this instruction?
"If you step on something without shoes, you might not feel it; this could possibly cause injury to your foot."
A nurse teaches the patient about the gate control theory. Which statement made by a patient reflects a correct understanding about the relationship between the gate control theory of pain and the use of meditation to relieve pain?
"Meditation controls pain by blocking pain impulses from coming through the gate."
A nurse is caring for a patient who is experiencing pain following abdominal surgery. Which information is important for the nurse to share with the patient when providing patient education about effective pain management?
"We should work together to create a schedule to provide regular dosing of medication."
The nurse is assessing how a patient's pain is affecting mobility. Which assessment question is most appropriate?
"What activities, if any, has your pain prevented you from doing?"
A nurse is caring for a patient who recently had abdominal surgery and is experiencing severe pain. The patient's blood pressure is 110/60 mm Hg, and heart rate is 60 beats/min. Additionally, the patient does not appear to be in any distress. Which response by the nurse is most therapeutic?
"What would you like to try to alleviate your pain?"
The nurse has brought a patient the scheduled pain medication. The patient asks the nurse to wait to give pain medication until the time for the dressing change, which is 2 hours away. Which response by the nurse is most therapeutic?
"Would you like medication to be given for dressing changes in addition to your regularly scheduled medication?"
The nurse is teaching a student nurse about pain assessment scales. Which statement by the student indicates effective teaching?
"You cannot use a pain scale to compare the pain of my patient with the pain of your patient."
A nurse is providing discharge teaching for a patient with a fractured humerus. The patient is going home with hydrocodone. Which important patient education does the nurse provide?
"You need to drink plenty of fluids and eat a diet high in fiber."
The nurse is administering ibuprofen (Advil) to an older patient. Which assessment data causes the nurse to hold the medication?
-Patient states allergy to aspirin. -Patient reports past medical history of gastric ulcer.
The nurse is preparing pain medications. To which patient does the nurse anticipate administering an opioid fentanyl patch?
A 50-year-old patient with prostate cancer
The nurse is caring for a group of patients. Which task may the nurse delegate to the nursing assistive personnel (NAP)?
Administer a back massage to a patient with pain.
A nurse receives an order from a health care provider to administer hydrocodone and acetaminophen (Vicodin ES 7.5/750), to a patient who is experiencing 8/10 postsurgical pain. The order is to give 2 tablets every 6 hours by mouth as needed for pain. What is the nurse's next best action?
Ask the health care provider to verify the dosage and frequency of the medication.
An oriented patient has recently had surgery. Which action is best for the nurse to take to assess this patient's pain?
Ask the patient to rate the level of pain.
A nurse is providing medication education to a patient who just started taking ibuprofen. Which information will the nurse include in the teaching session?
Ibuprofen inhibits the production of prostaglandins.
The nurse is caring for an infant in the intensive care unit. Which information should the nurse consider when planning care for this patient?
Infants respond behaviorally and physiologically to painful stimuli.
A patient is receiving opioid medication through an epidural infusion. Which action will the nurse take?
Label the tubing that leads to the epidural catheter.
The nurse is caring for two patients; both are having a hysterectomy. The first patient is having the hysterectomy after a complicated birth. The second patient has uterine cancer. What will most likely influence the experience of pain for these two patients?
Meaning of pain
A woman is in labor and refuses to receive any sort of anesthesia medication. Which alternative treatment is best for this patient?
Relaxation and guided imagery
A patient arrives at the emergency department experiencing a headache and rates the pain as 7 on a 0 to 10 pain scale. Which nonpharmacological intervention does the nurse implement for this patient while awaiting orders for pain medication from the health care provider?
Softly plays music that the patient finds relaxing
A nurse is caring for a patient who fell on the ice and has connective tissue damage in the wrist and hand. The patient describes the pain as throbbing. Which type of pain does the nurse document in this patient's medical record?
Somatic pain
The nurse is assessing a patient for opioid tolerance. Which finding supports the nurse's assessment?
The patient needs increasingly higher doses of opioid to control pain.
A patient who had a motor vehicle crash 2 days ago is experiencing pain and is receiving patient-controlled analgesia (PCA). Which assessment finding indicates effective pain management with the PCA?
The patient rates pain at a level of 2 on a 0 to 10 scale.
The nurse is administering pain medication for several patients. Which patient does the nurse administer medication to first?
The patient who is experiencing 8/10 pain and has an immediate order for pain medication
A nurse is caring for a patient who recently had spinal surgery. The nurse knows that patients usually experience acute pain following this type of surgery. The patient refuses to get up and walk and is not moving around in the bed. However, the patient is stoic and denies experiencing pain at this time. What most likely explains this patient's behavior?
The patient's culture is possibly influencing the patient's experience of pain.
The nurse is evaluating the effectiveness of guided imagery for pain management as used for a patient who has second- and third-degree burns and needs extensive dressing changes. Which finding best indicates the effectiveness of guided imagery?
The patient's need for analgesic medication decreases during the dressing changes.
The nurse is caring for a 4-year-old child who has pain. Which technique will the nurse use to best assess pain in this child?
Use the FACES scale.
A nurse is assessing a patient who started to have severe pain 3 days ago. When the nurse asks the patient to describe the pain, the patient states, "The pain feels like it is in my stomach. It is a burning pain, and it spreads out in a circle around the spot where it hurts the most." Which type of pain does the nurse document the patient is having at this time?
Visceral pain
